Ledipasvir/Sofosbuvir

Generic: ledipasvir-sofosbuvir

ANTIVIRALS

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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Harvoni 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via Ledipasvir-Sofosbuvir 		Brand-Preferred ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via Harvoni 		Tier 2 - Preferred Brand ✓ — — PA
BCBS Federal Basic Option 2026
via Harvoni 		Tier 4 - Preferred Specialty ✓ — — PA
BCBS Federal Standard Option 2026
via Harvoni 		Tier 4 - Preferred Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Advantage 2026 Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Local 2026 Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Care 2026 Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Value 2026 Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Advantage 2026
via Harvoni 		Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Home with UNC Health Alliance 2026
via Harvoni 		Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Local 2026
via Harvoni 		Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Care 2026
via Harvoni 		Tier 3 - High Cost Brand ✓ — — Restricted Access PA
BCBSNC Blue Value 2026
via Harvoni 		Tier 3 - High Cost Brand ✓ — — Restricted Access PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze RD 5000 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 2200 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold 1500 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect myDiabetesCare Bronze
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 5500 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD 6000 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 3500 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 3500 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze CMS Standard
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold RD CMS Standard
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD CMS Standard
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold CMS Standard
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD CMS Standard
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver CMS Standard
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 6500 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 3000 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 5000 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 4400 Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 7000 HSA Indiv Med Deductible
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect myDiabetesCare Silver
via Ledipasvir-Sofosbuvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
HealthSpring True Choice (PPO)
via Harvoni 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring TotalCare (HMO D-SNP)
via Harvoni 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP)
via Harvoni 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred (HMO)
via Harvoni 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred Select (HMO)
via Harvoni 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred Savings (HMO)
via Harvoni 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred Plus (HMO)
via Harvoni 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Ledipasvir-Sofosbuvir 		Non-Preferred ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Harvoni 		Tier 5 - Preferred Brand Specialty ✓ — ✓ For genotypes PA | QL
NC State Health Plan - 70/30 Standard PPO 2026
via Harvoni 		Tier 5 - Preferred Brand Specialty ✓ — ✓ For genotypes PA | QL
NC State Health Plan - HDHP 2026
via Harvoni 		Tier 5 - Preferred Brand Specialty ✓ — ✓ For genotypes PA | QL
Source: CMS QHP JSON  ·  Checked: 17 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Bronze Classic Standard | with Atrium Health
via Harvoni 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Classic Standard
via Harvoni 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Classic Standard
via Harvoni 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Classic Standard | with Atrium Health
via Harvoni 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Classic Standard | with Atrium Health
via Harvoni 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Classic Standard
via Harvoni 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Elite Saver Plus
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple PCP Saver
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Classic 4700
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Secure
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Classic
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Elite + PCP Saver Plus
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Diabetes
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Gold Elite Saver Plus | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple PCP Saver | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Diabetes | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Classic | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Elite + PCP Saver Plus | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Classic 4700 | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Secure | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
AIAN Cost Share | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
AIAN Cost Share
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Chronic Care CKM | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Simple Diabetes | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Simple Chronic Care CKM | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Harvoni 		Tier 5 - Specialty ✓ — ✓ PA | QL
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